Individual provider Active NPI

Ann Z Song, M.D.

  • Neurology Physician
  • Greeley, CO
National Provider Identifier
1649239609
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
CDR.0002948 Issued in CO
Practice address
2410 W 16TH St
Greeley, CO 80634-6004
Phone
(970) 810-5612
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X D0057877 MD
Neurology Physician 2084N0400X CDR.0002948 CO Primary

Addresses

Primary practice location

2410 W 16TH St
Greeley, CO 80634-6004

Mailing address

2410 W 16TH St # 80634
Greeley, CO 80634-6004
Phone (970) 810-5612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210609000943 VT Practitioner - Neurology 3476524240 Reassigns benefits to 1 organization
I20230815003604 CO Practitioner - NeurologyPractitioner - Psychiatry 3476524240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
CDR.0002948COMDNeurology Physician
D0057877MDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc Neurology CurrentSince Jun 1, 2021 Accepting new patients
Helixcare Medical Group, LLC Past Accepting new patients
DRS Fleishman & Strauss LLC Neurology Past Accepting new patients

Locations

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

Interoperability endpoints

  • Direct secure messaging: asong556740@direct.peacehealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1649239609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 W 16TH ST # 80634",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346004",
            "telephone_number": "970-810-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346004",
            "telephone_number": "970-810-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "ANN",
        "middle_name": "Z",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D0057877",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "CDR.0002948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.